Lecture 8 - Elbow ax

Question 1

3 joints that make up the cubital articulations

Answer 1

Ulnohumeral
Radiohumeral
Superior radioulnar

Question 2

Primary role of the elbow

Answer 2

Help position the hand in the appropriate location to perform its function

Question 3

Type of joint for ulnohumeral

Answer 3

Uniaxial hinge joint

Question 4

Ulnohumeral joint - rest pos. + close packed + capsular

Answer 4

Resting position = 70d elbow flexion, 10d supination
Close packed position = extension with supination
Capsular pattern = flexion, extension

Question 5

Type of joint for radiohumeral

Answer 5

Uniaxial hinge joint between capitulum and head of radius

Question 6

Radiohumeral joint - rest pos. + close packed + capsular pattern

Answer 6

Resting position = elbow fully extended and forearm fully supinated
Close packed position = elbow flexed to 90 and forearm supinated to 5
Capsular pattern = flexion>extension>supination>pronation

Question 7

Type of joint for superior radioulnar

Answer 7

Uniaxial pivot joint

Question 8

Ligament holding the superior radioulnar in place

Answer 8

Annular ligaments

Question 9

Superior radioulnar - rest pos. + close packed + capsular pattern

Answer 9

Resting position = 35 supination and 70 elbow flexion
Close packed position = 5 supination
Capsular pattern = equal limitation of supination and pronation

Question 10

name the 3 ligaments of the elbow

Answer 10

UCL
RCL
Annular lig.

Question 11

Normal carrying angles for male and female

Answer 11

Male = 5 to 10 degrees
Female = 10 to 15 degrees
> 15 d = cubitus valgus
< 5 to 10 degrees = cubitus varus

Question 12

Functional assessment of elbow positioning

Answer 12

Between 30 and 130d of elbow flexion
Between 50d of pronation and 50d of supination

Question 13

Examples of functional assessment

Answer 13

Turning door knob
Throwing a ball
Lifting objects
Carrying grocery bags
Push-up

Question 14

Microtrauma or macrotrauma is the cause for epicondylitis?

Answer 14

microtrauma (repetitive)

Question 15

Tennis elbow

Answer 15

Lateral epicondylitis

Question 16

Golfer’s elbow

Answer 16

Medial epicondylitis

Question 17

Name the 3 tests for lateral epicondylitis

Answer 17

Cozen’s test
Mill’s test
Maudsley’s test

Question 18

Joint dysfunction - radiohumeral, how to test?

Answer 18

Place pt in position of pain -> radially deviates (compresses radius against humerus)

Question 19

Joint dysfunction - ulnohumeral, how to test?

Answer 19

Position at point of pain -> ulnar deviation (compresses ulna against humerus)

Question 20

Tests for ulnar nerve (3)

Answer 20

Tinel’s sign
Wartenburg’s - add of 5th finger
Elbow flexion test

Question 21

Tests for median nerve (2)

Answer 21

Resisted pronator teres
Pinch grip (ant. interosseous n.)

Question 22

Name the 3 reflexes to test at elbow

Answer 22

Biceps (C5-C6)
Brachioradialis (C5-C6)
Triceps (C7-C8)

Question 23

Radial n. palsy other name

Answer 23

Saturday night palsy

Question 24

Cause and sx of radial n. palsy

Answer 24

Cause: fx at humerus or compression in radial groove
Sx: wrist drop, weak sup. sensory loss in forearm, inability to extend fingers

Question 25

Posterior interosseous n. syndrome cause

Answer 25

Compression by supinator (arcade of frohse)

Question 26

Sx of post. int. n. syndrome

Answer 26

Inability to extend fingers at MCP
Normal sensation, but extensor carpi ulnaris affected

Question 27

Pronator teres syndrome affects which nerve

Answer 27

Median nerve (C6-C8, T1)

Question 28

Sx of pronator teres syndrome

Answer 28

• Pain in forearm
• Weakness in hand grip
• Pain NOT worse at night
• Numbness and tingling in index and thumb

Question 29

Difference between carpal tunnel syndrome and pronator teres syndrome?

Answer 29

Carpal tunnel = pain gets worse at night

Question 30

Sx of anterior interosseous n. syndrome

Answer 30

• Weakness in flex. digitorum profundus & longus
• “Pinch attitude”
• No abnormal or reduced sensation

Question 31

What nerve is affected by cubital tunnel syndrome

Answer 31

Ulnar n. (C7-C8, T1)

Question 32

Sx of cubital tunnel syndrome

Answer 32

Numbness/tingling in ulnar aspect of hand
Weakness in hand grip
Atrophy in hypothenar and 1st web space
Sensory loss (ulnar)

Question 33

2 tests that will reveal cubital tunnel syndrome

Answer 33

Benediction hand
Froment’s sign